Uncompensated care costs could soar despite reform

The combination of individual states rejecting Medicaid expansion as part of the Affordable Care Act and cuts in disproportionate share hospital (DSH) payments could cause uncompensated care tabs to balloon in the coming years, according to a new report from the National Association of Public Hospitals and Health Systems (NAPH).

The NAPH data concluded that total uncompensated care costs could rise $53.3 billion by 2019. That is based on an assessment of states rejecting Medicaid funding while DSH payments are cut by as much as $14.1 billion.

The association made its calculations using data from the Congressional Budget Office, which estimates as many as 10 million fewer Americans will have healthcare coverage now that states can opt out of expanding Medicaid, The Washington Postreported.

"Congress certainly didn't foresee this level of uninsured and uncompensated care when it enacted the ACA," NAPH CEO Bruce Siegel, M.D., said last week in a statement. "In this light, the deep cuts to disproportionate share hospital payments over the same period are simply untenable and will prove devastating to society's most vulnerable and to the providers who care for them," he said.